Post on 30-May-2018
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
1/35
Understandingandcopingwithtraumaticstress
OnlineTrainingModule
Understandingandcopingwithtraumaticstress
byLisaMcKay
SELFSTUDYMODULE1
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
2/35
Understandingandcopingwithtraumaticstress
Headington Institute 20071
HeadingtonInstitute
200EastDelMarBlvd
Suite119
Pasadena,CA91105
USA
Phone:6262299336
www.headingtoninstitute.org
Theinformationcontainedinthesemodulesisprovidedsolelyforeducationalpur
poses.Theselfexaminationexercisesandscalesonthiswebsitearenotintendedto
beused
as
diagnostic
or
treatment
tools.
Any
concerns
you
might
have
about
men
talhealthissuesshouldbediscussedwithaqualifiedmentalhealthprofessional.If
anyofthematerialinthismoduleraisesconcernsforyou,pleasecontacttheHead
ingtonInstitutestafforotherappropriatelyqualifiedmentalhealthprofessionals.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
3/35
Headington Institute 20072
TABLEOFCONTENTS
Introduction
Stressandhumanitarianwork3
3
Study text
Howcan
humanitarian
work
be
stressful?
Keyconceptsregardingtraumaticstress
Culturalissues
Signsofstress
Riskandprotectivefactors
Burnout
Examiningyourownwellbeing
Combatingstressandburnout
6
6
8
12
13
16
20
23
24
Quiz
Testmyknowledge
29
References
Resources
33
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
4/35
Understandingandcopingwithtraumaticstress
Headington Institute 20073
Introduction:StressandhumanitarianworkForsevenyearsIlivedamongthosewhoseliveshadbeentorninpiecesbyrockets,
mines,executions,rape,torture,andanunspeakableclimateoffearthatcouldshat
terthesanityofanyhumanmind.AsIworkedinthewarsandpostwarsituationsin
Afghanistan,theBalkans,Cambodia,andtheDemocraticRepublicofCongo,Ifound
myselfinenvironmentsforwhichnohumanbeingisprepared.Theseareextreme
situations,invokingoursurvivalinstincts,expectingustotapintoourultimateca
pacitiesofstrengthandcourageWhenyouseetheimmensesufferingofthoseyou
areattemptingtohelp,youaremorallyandemotionallycompelledtoputasideyour
ownfears.Temporarily.Youfunctionunderpressureinthepresentbypostponing
yourrelieftothefuture.Thatkindofpressuredlivingandworkingbuildstensions
withinthatwillhavetoreleasedatsomepoint
YasminSherifonherworkwiththeUnitedNations
(quotedinDanieli,2002,p.62)
Humanitarianworkerscomeinmanyshapesandsizes.Theyworkinonsiterecovery
andreliefmissions,education,healthtraining,agriculturalassistance,communitymo
bilization,economicdevelopment,waterandsanitation,conflictresolution,andadvo
cacy.The
common
thread
across
these
diverse
roles
is
aservice
orientation
in
the
face
ofsufferingandneed.Everyonewhoworksforahumanitarianorganizationisahelper
insomecapacity.
Thetraditionalimageofhelpersisthattheyareselflessandtireless.They,themselves,
tendtoexpectthatbecausetheirworkisforanoblecause,theywillsomehowbeim
munetopressure.However,humanitarianworkersareimpactedbytheirwork.Theyoftenleaveattheendofthedayfeelingthattheyhavenotdoneenoughbecausethe
scopeoftheneedissooverwhelming.Theycanbetroubledbywitnessingviolenceand
poverty,andbyhearingthestoriesofrefugeesanddisastersurvivors.Inaddition,in
todays
global
climate,
many
face
danger
during
the
course
of
their
work.
In
this
serviceorientedprofession,manyhumanitarianworkersstruggletofindahealthybalance
betweenthedemandsoftheworkandtheneedtopaysomeattentiontotheirown
physicalandemotionalwellbeing.
Toooften,humanitarianworkersconsistentlyfailtopayanyattentiontotheirownself
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
5/35
Headington Institute 20074
careandwellbeing.Humanitarianworkcanbedemanding,bothphysicallyandemo
tionally,andthosewhoneglecttheirownneedseventuallyfindthemselvespayingthe
price.Theygetsickmoreeasily,andstaysicklonger.Theyfeeltired,drained,andworn
out.Theymaystarttofeelanxious,cynicalorhopeless.Relationshipssuffer.Theycan
starttoactinwaysthathurtthemselvesbyusingdrugs,alcohol,orengaginginrisky
behavior.Intheend,thosewhodecidedtodohumanitarianworktohelpotherscan
enduphurtingthemselvesandthosearoundthem.
Humanitarianworkerscanbesupportedinseveralwaysthatreducetheliklihoodof
developingstressrelatedproblems.Thefirsttypeofimportantsupportistoprovide
basicinformation
about
stress,
trauma,
normal
reactions
to
stressful
situations,
and
helpfulcopingstrategies.Everyhumanitarianworkershouldunderstandtraumatic
stressandknowhowtohelppreventoralleviatetraumaticstressreactions.Knowl
edgeaboutnormalreactionstostressfulsituations,andactionregardinghealthyself
carepractices,worktogethertoprotectphysicalandemotionalwellbeing.Enhanced
wellbeingmeansthathumanitarianworkersremainhappier,healthierandmoreef
fectiveintheirwork,longer.
ThisisthefirstinaseriesofonlinetrainingmodulesproducedbytheHeadingtonInsti
tutethatexplorevariousaspectsoftraumaticstressasitrelatestohumanitarianwork.
Thisintroductory
module
aims
to
help
humanitarian
workers:
1. Understandthedifferenttypesoftraumaticstressassociatedwiththeirwork
2. Recognizethesignsofstressandburnout
3. Learnselfcaretechniquestohelpalleviatestressreactions
Bytheendofthismoduleyouwillbetterunderstand:
Thenatureoftraumaticstress
Threecommontypesoftraumaticstressassociatedwithhumanitarianwork
criticalincidentstress,vicarioustrauma,andchronicstress
Theeffects
of
traumatic
stress
Whyitisimportantforhumanitarianworkerstoknowabouttheseeffects
Howtomonitoryourownwellbeing
Selfcaretechniquestohelpalleviatestressreactions
Wheretogetmoreinformationforcontinuedlearningorpersonalassistance.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
6/35
Understandingandcopingwithtraumaticstress
Headington Institute 20075
Ofcourse,thisstudymoduleisnotacomprehensivetreatmentofthesubjectofhu
manitarianworkandstressandtrauma.Instead,thismoduleprovidesanoverviewof
criticalincidentstress,vicarioustrauma,andchronicstress.Itprovidesaframeworkfor
astudyprogramthatcanhelpthoseinterestedinthesubjectlearnaboutitattheir
ownpaceandenhancetheirunderstandingwithadditionalresources.Thisintroduc
torymodulefocusesprimarilyonchronicstress,burnout,andselfcarestrategies.Ad
ditionalonlinemodulesinthisseriesfocusmorespecificallyon:
Traumaandcriticalincidentcare
Reentryissuesandworklifebalance
Copingwith
vicarious
trauma
Humanitarianwork,traumaticstressandspirituality
Asyouworkthroughthestudysectionsinthismodule,taketheopportunitytoreflect
onhowtheinformationpresentedisrelevanttoyourworkandlife.Personalreflection
questionshavebeenprovidedattheendofeachstudysectiontohelpyouthroughthis
process.Youmayfinditparticularlyhelpfultowritedownyouranswerstotheseques
tions.
Whenyouhavegonethroughallthelessonsinthismodule,trytestingyourcompre
hensionby
taking
the
online
quiz.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
7/35
Headington Institute 20076
PartOne:Howcanhumanitarianworkbestressful?
Humanitarianworkcanbeamongthemostexciting,enriching,andimportantworkin
theworld.Ithas:
Moralappeal:Itisusuallyserviceworkforworthycauses.
Personalappeal:Workinginternationallyandbeingexposedtodifferentcul
turesstretchesandchallengesindividualstogrow.
Adventurousappeal:Humanitarianworkersoftenserveinthemidstofextreme
and
challenging
situations.
Facingthechallengesofworkinginthehumanitarianfieldcanbestimulatingandrichly
rewarding,bothpersonallyandprofessionally.However,withrewardscancomesome
personalcoststhatresultfromlivingandworkinginthemidstofdisastrous,violent
situationsandfacingchallengesthatoftenseemoverwhelming.Someofthepressures
associatedwithhumanitarianworkinclude:
Threatandviolence:Whetheritistheresultofnaturaldisaster,civilconflict,or
increaseddomesticcrime,manyhumanitarianworkerswitnessviolenceandits
aftereffects,orareexposedtoupsettingstoriesofpersonaltragedy.
Socialdislocation:
Many
humanitarian
workers
experience
separation
from
theirsocialsupportnetworks,suchasfriendsandfamily.
Culturaldislocation:Livingandworkinginanothercountryoftenmeansthat
newrulesforcommunicatingpolitelyandeffectivelymustbelearned.
Spiritualdislocation:Separationfromfamiliarreligiousframeworks,exposure
toradicallydifferentviewsaboutspiritualityandreligion,andexposuretotrau
maticeventscanchallengeandalterahumanitarianworkersreligiousbeliefs.
Povertyanddeprivation:Humanitarianworkersoftenliveandworkinthe
midstofextremepovertyanditsassociatedsufferingwithoutenoughresources
availabletocombattheproblems.Thiscanleadtofeelingsofimpotenceand
beingoverwhelmed.
Moraldilemmas:Humanitarianworkmayinvolvefacingmoraldilemmassuch
asnegotiatingwithwarlords,concernthataidmaybeprolongingaconflict,or
witnessinghumanrightsviolationsbutbeingunabletorespondduetoopera
tionalconsiderations.
Theworkenvironment:Commonworkstressorsinclude:interpersonalandcul
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
8/35
Understandingandcopingwithtraumaticstress
Headington Institute 20077
turallybasedconflictamongteammemberswhoareforcedintoprolonged
closenessandinterdependence;roleambiguity;lackofappropriateresources,
personnel,time,logisticalsupport,orskillstodothejobexpected;andheavy
workloadandlonghours.
Forpersonalreflection
Whatdoyoufindespeciallyrewardingaboutworkinginthehumanitarian
field?
Whatdoyoufindespeciallychallenging(physically,emotionally,mentally,
spirituallyand
relationally)
about
working
in
the
humanitarian
field?
Howdoyoufindyourselfreactingtosomeofthechallengesyouhave
listed?
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
9/35
Headington Institute 20078
PartTwo:Keyconceptsregardingtraumaticstress
Stresscanbedefinedasanydemandorchangethatthehumansystem(mind,body,spirit)isrequiredtomeetandrespondto.Stressisthereforeapartofnormallife.
Withoutchallengesandphysicaldemands,lifewouldbeboring.Stress,however,be
comesdistress(ortraumaticstress)whenitlaststoolong,occurstoooften,oristoo
severe.Itisalsoimportanttonotethatwhatisdistressfulforonepersonmaynotnec
essarilybedistressfulforanother.Yourindividualperception(howthreatenedyoufeel
andhowmuchcontrolyouhaveoverthecircumstances)canaffectthedegreeofdis
tressyoupersonallyfeel.Traumaticstresscanthereforebedefinedasthereactionto
anychallenge,demand,threatorchangethatexceedsourcopingresourcesandresults
indistress.
Therearethreemaintypesoftraumaticstresstowhichhumanitarianworkersareex
posed:
Criticalincidentstressor acutestress
Definition:Thesearetwotermsusedtorefertotraumareactionsthatoccurasthere
sultofatraumaticeventduringwhichanindividualisseriouslythreatenedbyharmor
death.These
types
of
events
are
often
referred
to
as
criticalincidentsandareunusual
andintense.Examplesofcriticalincidentsthathumanitarianworkersmayexperience
includebeingassaulted,beinginsituationswheremanypeoplearedying,beingwithin
rangeofgunfire,orexperiencingcaraccidents,bombings,kidnappingsandcarjackings.
Reactions:Experiencingacutestressreactions(alsoreferredtoascriticalincidentstressreactions)afteracriticalincidentisanormalresponsetoanabnormalsituation.
Thetraumaticeventtriggersanintensefightorflightresponsethatresultsinaseries
ofapproximately1500biochemicalreactionsinthebody.Forexample,sharpincreases
inthelevelsofstresschemicalssuchasadrenalineandcortisolleadtoanincreased
heartrate
and
changes
in
blood
flow
as
you
prepare
to
deal
with
the
threat.
Whoisatrisk?Thistypeoftraumaticstresstendstobemoreproblematicforhumanitarianworkerswhoarepostedoutsidethedevelopedworld.Researchsuggeststhat
mostworkersinthefieldwillexperienceatleastoneseriouslydisturbingorfrighten
ingincidentduringthecourseoftheirwork.Approximately25%ofhumanitarianwork
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
10/35
Understandingandcopingwithtraumaticstress
Headington Institute 20079
ersincomplexhumanitarianemergencysituations(e.g.,workingincountriessuchas
Iraq,AfghanistanandtheDemocraticRepublicoftheCongo)canexpecttoundergoa
lifethreateningexperience.
[Formoreondetailedinformationontraumaandcriticalincidentstressseeouronline
trainingmodule,Traumaandcriticalincidentcare]Vicarious trauma or secondary traumatization
Definition:Thesetermsrefertostressandtraumareactionsthatcanoccurinresponse
towitnessing
or
hearing
about
traumatic
events
that
have
happened
to
others.
In
thesecases,otherpeoplearethevictims,andyouseethemundergoingsuffering,or
hearabouttraumaticeventsthathavehappenedtothem.
Reactions:Vicarioustraumacantriggermanyofthesamereactionsthatoccurwhen
youpersonallyfaceacriticalincident.Signsandsymptomsaresimilar,althoughusually
lessintense,thanthosetriggeredbydirectexposuretotraumaticevents.However,in
somecasestheleveloftraumatizationcanbealmostasgreatinsecondaryvictimsas
inprimaryones.Whoisatrisk?Itisnowwidelyacceptedthatinteractionwithvictimsoftraumaticexposureplaceshelpersathighriskofexperiencingsomeformofsecondarytraumatic
stressresponse.Humanitarianworkersinallrolesregularlyheardistressingstories,
andfacetherealitiesofviolence,povertyanddisaster.Vicarioustraumaistherefore
inherenttohumanitarianworkandproblematicforbothfieldandhomestaff.Therele
vantissuebecomeslessabouthowtoavoidvicarioustrauma,andmoreabouthowto
prepareforanddealwithit.
[Formoreondetailedinformationonvicarioustraumaseeouronlinetrainingmodule,
Vicarioustrauma]Cumulative stress
Definition:Cumulativestressreactionsarealessdramatic,moregradualformofstressreaction.Theyareusuallyrelatedtolowintensitybutmorechronicstressorsthatper
vadeapersonslifeandpileup,oneontopoftheother.Somecommonsourcesof
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
11/35
Headington Institute 200710
chronicstressforhumanitarianworkersinclude:
Achaoticandreactiveworkenvironment
Feelingoverwhelmedbyunmetneeds
Tightdeadlinesandstressedcoworkers
Communicationdifficultiesduetopersonalityandculturaldifferences
Inadequatepreparationandbriefing
Beingaskedtocompletetasksoutsideyourareaoftrainingandcompetence
Facingmoralandethicaldilemmas
Isolationfromyourfamiliarsocialsupportnetwork
Chronicsleep
deprivation
Traveldifficultiesanddelays
Reactions:Thenegativeeffectsofeverydaystressorsbuildupovertime.Chronicstressorstriggerenduringstressreactionsthatcangrowinintensityandbecomeprob
lematicovertime.Thepresenceofmultiplechronicstressorsisoftenabetterpredictor
ofhigherstresslevelsthantheoccurrenceoftheoccasionalcriticalincident.Ase
quenceofrelativelymildstressfuleventscanultimatelycreatehighstresslevelsifnot
dealtwitheffectivelyonanongoingbasis.
Whoisatrisk?Nearlyeveryoneexperiencesthistypeofstressreactionatsomepointduringtheirlives.However,regardlessoftheirparticularrole,mosthumanitarianworkersareexposedtoelevatedlevelsofoccupationrelatedchronicstressors.Inaddi
tiontotypicalchronicstressors(suchastrafficdelaysandjobevaluations),humanitar
ianworkersalsofacesomeofthechronicchallengesthatcomewithworkinginacrisis
culture.Howyoumanagetostriketherightbalancebetweentheurgencyofthework
andotherareasoflifeisthemostrelevantissue.Humanitarianworkerswhodonttake
chronicstressseriouslyandproactivelypreparetomeetthechallengesrunarealrisk
ofburningoutwithin3to5yearsofhighimpactwork.
Allthreetypesoftraumaticstresscanbeproblematicforhumanitarianworkers.How
ever,research
and
anecdotal
evidence
suggests
that
chronic
stress
reactions,
such
as
burnout,arelikelytobeproblematicforthegreatestnumberofhumanitarianworkers.
Therefore,theremainderofthismodulefocusesprimarilyonrecognizingandmanag
ingcumulativeandchronicstressreactions.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
12/35
Understandingandcopingwithtraumaticstress
Headington Institute 200711
Caseinpoint
Theperiodbeforedeploymentwasextremelystressful.Therewassomuchtodo
andmyexperiencemademefeelinadequatelyprepared.Myimmediatemedical
chainofcommandseemedtoofferlittleornosupportoradvice.InKosovoIspent
sevenextremelydemandingmonths.Ifeltcompletelyresponsibleforensuringthat
nothingwouldgowrong.IknewthatIwaspushingmyselftoohardandneglecting
myownpersonalneedsbutIwasntabletoletup.
CherylNetterfieldonherexperienceasamedicalofficerdeployedtoKosovo
(quotedinDanieli,2002,p.50)
Forpersonalreflection
Whichtypeoftraumaticstress(acute,vicarious,orcumulative)ismost
problematicortroublesomeforyou?
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
13/35
Headington Institute 200712
PartThree:Culturalissues
Traumaticstressisnotjustaproblemforwesternhumanitarianworkerswhorelocate
(usuallytemporarily)todevelopingcountriesanddisasterzonesforthesakeoftheir
job.Infact,themajorityofhumanitarianworkersworldwidearefromnonwesterncul
turalbackgrounds,workingintheirhomecountry.Thesenationalhumanitarianwork
ersarenotexemptfromexperiencingtraumaticstress.
Physiologicalandemotionalresponsestodisasterarebroadlysimilaralloverthe
world.However,anindividualsinterpretationofstressandtraumaisshapedtosome
extentbyculture,socialcontext,andpersonalexperience.Itisimportanttoacknowl
edgethattherearedifferencesacrossculturesinhoweventsareexperiencedandhow
traumaticstressisexpressed.
Humanitarianworkersfromnonwesternbackgroundsreadingthismodulewillfindit
helpfultokeepthefollowingquestionsinmindastheyprogressthroughtherestof
thestudytext.Therearemanycommonalitiesacrossculturesinsignsandsymptomsof
stress,andeffectiveselfcaretechniques.However,therearesomeimportantdiffer
encestoo.Forexample,anindividualfromWestAfricamayexperienceandreadilydis
cussphysicalsignsofstressandtension,butfeelmuchlesscomfortablediscussing
emotionalreactions.
In
another
example,
seeking
solitude
may
be
avery
effective
self
caretechniqueforpeoplefromFinland.SomeonefromIndia,however,maynotfind
solitudehelpfulandenergizing,butstrangeanddiscomforting.Westernerslivingand
workinginternationallyshouldalsotakethetimetoconsiderstressandselfcarecon
ceptsinregardstotheirhostculture.
Whatconstitutesstressandtraumainthelifeofthisculture?Forexample,howisstressconceptualized?Isthereaconceptofindividualstressinthiscultureor
isitexperiencedandunderstoodmainlythroughfamilyandgroupprocesses?
Howisstresstypicallyexperiencedinthisculture?Whataretypicalindicatorsofstress?
Does
stress
tend
to
be
experienced
physically,
emotionally,
mentally,
relationally,spirituallyorthroughbehavior?Howisstressusuallyexpressedin
thisculture?
Whathavepeoplefromthisculturetraditionallydonetodealwithstress?Whatistheroleoftheindividualorthecommunityinmanagingstress?Whatindividual,socialandcultural,oralandbehavioralmechanismsaretypicallyusedto
dealwithstress?
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
14/35
Understandingandcopingwithtraumaticstress
Headington Institute 200713
PartFour:Signsofstress
Signs of stress
Experiencesthatareperceivedasthreateningordemandingtriggeraseriesofapproxi
mately1,500biochemicalreactionswithinthebody.Stresschemicals(suchasadrena
lineandcortisol)aredumpedintothebloodstreamandtriggerthefightorflightre
sponse.
These
chemicals
prepare
us
to
deal
with
threatening
and
dangerous
events.
For
exam
ple,anelevatedheartratemeansthatmorebloodisbeingpumpedtoourmusclesand
brainsothatwecanassessthethreatandeitherfight,orrunawayfaster.However,
thefightorflightresponseisntgoodathelpingusdealwithmanyofthechronicstressorsthatweareexposedtoinlife.Formostpeople,fightingorrunningawayare
notrealisticoptionsfordealingwithstressorstheyencounteratworknotifthey
wanttokeeptheirjobs!
So,iffightingandrunningawayarentfeasibleoptions,howdowemanagethese
stressreactions?Agoodfirststepislearningtorecognizethesignsofstressthatmost
oftenappearinourlives.Reactionstostressarecomplexandtendtomanifestindifferentwaysfordifferent
people.Thecharacteristicsoftheperson(e.g.,theirphysicalandmentalhealth,levelofsocialsupport,andprevioushistoryoftrauma)interactwiththecharacteristicsoftheevent(e.g.,themagnitudeandtypeofstressfulevent,thepresenceofcumulativestressorsandotherlifeevents)toinfluencepeoplesexperiencesandreactions.
Stresschemicalscantriggerphysicalreactionsthatcanlingerfordays,weeks,orsome
timesmonths.Inadditiontotriggeringphysicalreactions,stresshormonesandchemi
calsaffectbrainchemistryandimpactthewaywethinkandfeel.Overtime,asour
bodies,emotions
and
minds
are
affected
by
stress,
this
has
implications
for
our
spiri
tualselvestoo.Spiritualityisacorecomponentofhumannature.Spiritualityshapes
andinformsoursenseofmeaningandpurpose,faithandhope.Whetherexperienced
asanexplicitbeliefinadeity,amorediffusesenseoftranscendenceorconnectedness
withnatureoralifeforce,orabeliefinhumannatureandsolidarity,mostpeoplebe
lievethattobefullyhumaninvolvesmorethansimplythephysicaldimensionsofexis
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
15/35
Headington Institute 200714
tence.Overtimethetypesofchallengesthataidworkersfacecanimpacttheirworld
viewtheirconceptionsofGod,humanity,andwheretheyderivetheirsenseofmean
ing,purposeandhope.Finally,withthemixofphysical,emotional,mentalandspiritual
symptoms,itsnotsurprisingthatstressoftenshowsupinourbehavior.Thefollowing
aresomecommonsignsofcumulativestress.
Risktaking
(suchasdriv
ingrecklessly)
Overeatingor
undereating
Increased
smoking
Listlessness
Hyper
alertness
Aggression
andverbal
outbursts
Alcoholand/or
druguse
Compulsive
behavior(i.e.
nervoustics
andpacing)
Withdrawal/
isolation
Promiscuity
Physical Emotional Mental Spiritual Behavioral
Sleepdistur
bances
Changes
in
appetite
Stomachup
sets
Rapidheart
rate
Fatigue
Muscletrem
orsandten
sion
Backand
neckpain
Headaches
Inabilityto
relaxandrest
Beingeasily
startled
Moodswings
Feelingover
emotional
Irritability
Anger
Depression
Anxiety
Emotional
numbness
Poorconcen
tration
Confusion
and
disorganized
thoughts
Forgetfulness
Difficultymak
ingdecisions
Dreamsor
nightmares
Intrusive
thoughts
Feelingsof
emptiness
Loss
of
mean
ing
Discourage
mentandloss
ofhope
Cynicism
Doubt
AngeratGod
Alienationand
lossofsenseof
connection
Risktaking
(suchasdriv
ing
recklessly)
Overeatingor
undereating
Increased
smoking
Listlessness
Hyper
alertness
Aggression
andverbal
outbursts
Alcoholand/or
druguse
Compulsive
behavior(i.e.
nervoustics
andpacing)
Withdrawal/
isolation
Promiscuity
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
16/35
Understandingandcopingwithtraumaticstress
Headington Institute 200715
Forpersonalreflection
Haveyounoticedanyofthesegeneralsignsofstresslately?
Whenyouareunderpressure,whichofthesesignsofstresstendtoappear
first? Followthislink(http://www.headingtoninstitute.org/Default.aspx?
tabid=1379)toaselfexaminationscaleifyouwouldlikeexplorewhether
youmightbedemonstratingsignsofstress.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
17/35
Headington Institute 200716
PartFive:Riskandprotectivefactors
Inadditiontolearningtorecognizeourownspecificearlywarningsignalssothatwe
canidentifywhenwereexperiencingunhealthylevelsofstress,itshelpfultoknow
whatriskandprotectivefactorswecarrywithus.Riskfactorsincreaseourvulnerability
toexperiencingtraumaticstressreactions.Protectivefactorsdecreaseourvulnerability
byincreasingourpersonalhardinessandresilienceandenablingustodealwithin
creasedlevelsofstresswithlessdistress.
Risk factors
Researchhasidentifiedseveralfactorsthatimpactthelikelihoodofexperiencingtrau
maticstressreactionswhenexposedtosufficientstressors.Theseare:
Thenatureandintensityoftraumaticeventsexperiencedinthepast:Thereis
noescapingourownpersonalhistoriescompletelywhenitcomestostressful
andtraumaticevents.Whileadesiretohelpothersinneedcanspringfromour
greatestpersonalwounds,itisimportanttorecognizethatconfrontingthe
traumaofotherscantriggerourownmemoriesofhurtandbetrayal.Thisisim
portanttokeepinmind,sincerecentresearchsuggeststhatatleastathirdof
humanitarianworkers
have
undergone
traumatic
events
prior
to
any
experi
encestheymayencounterinthefield.
Thenatureandintensityofthetraumaticorstressfuleventthattriggersthe
currentreaction:Thetypeofstressfuleventinfluencesthelikelihoodofexperi
encingstressandtraumareactions.Experiencingorwitnessingamanmadedis
asterinvolvinghumancruelty(suchasanarmedattack)isusuallymorestress
fulthanexperiencingorwitnessingnaturaldisasters.
Thenumberofstressorsexperienced:Thosewhoareexperiencingmultiplesig
nificantlifeeventsandchanges(suchasthedeathofaparentormovinginter
nationally)tendtobemorevulnerable.
Thelength
of
exposure
to
stressful
situations:Asexposurelengthens,riskincreases.
Organizationalfactors:Preliminaryresearchsuggeststhathumanitarianworkersidentifyorganizationalfactorssuchasteamrelationships,leadership,clarity
ofmissionobjectives,andagencystructure,astheirprimarycauseofchronic
stress.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
18/35
Understandingandcopingwithtraumaticstress
Headington Institute 200717
Historyofpreviouspsychiatricillness:Thosewithapriorhistoryofpsychiatric
illness,especiallythosewhohaveexperiencedacutestressdisorderorpost
traumaticstressdisorder,tendtobemorevulnerable.
Lackofsocialsupport:Socialsupportisveryimportantinprotectinghumans
fromtheeffectsofstressandtrauma.Recentresearchsuggeststhat,compared
tothosewithmediumtohighlevelsofsocialsupport,thosewithcompromised
socialsupportare4timesmorelikelytoexperiencetraumatizationand2.5
timesmorelikelytoexperiencesomeformofphysicalillness.Individualswith
outpartnersarealsoatgreaterrisk.
Pronouncedintroversion:Peoplewhoareintrovertedaretypicallymorevulner
able.
Negativityandpessimism:Habituallynegative,pessimisticindividualsaremore
vulnerabletostressrelateddysfunction.Inaddition,themorenegativetheir
appraisalofthemeaningfulnessoftheirhumanitarianmissionorworkassign
ment,themorevulnerabletheyare.
Protective factors
Incontrast,thefollowingfactorstendtohelppeoplethriveinthefaceofadversity.
Theybufferindividualsagainsttheeffectsofstressfulexperiences,andhelpthemcope
withthe
transitions
demanded
by
significant
life
events:
Socialsupport:Welldevelopedinterpersonalskills,extraversion,andtheabilitytosecureandmaintainagoodsocialnetworkarevitaltoemotionalhealthand
stability.Recentresearchsuggeststhatstrongrelationshipswithothersmaybe
evenmoreimportantthanpersonalcopingknowledgeandskills,andthebest
protectioninstressfulenvironments.
Optimismandhealthyselfesteem:Anoptimisticoutlook,regularexperiencesofpositiveemotions,ahealthyselfesteem,andfaithinselfaretraitsthatfos
terhardinessandresilience.
Spirituality:Spiritualityincorporatesanindividualsvisionofamoralorder
andsearchformeaningandpurpose,religiousbeliefs,andhopeforthefuture.
Ingeneral,spiritualityisaveryeffectiveprotectivefactor.Theexceptionsap
peartobewhenanindividualsspiritualityisnave(untestedand/ornot
thoughtfullyconstructed),orwhenindividualsareparticularlyrigidintheir
spiritualbeliefs.Intheseinstances,individualswhoarefacedwiththechal
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
19/35
Headington Institute 200718
lengesofhumanitarianworkappeartobemorevulnerabletotheshatteringof
rigidworldviews,lossofsenseofmeaningandpurpose,negativeselfimages,
andotherattendantpsychologicaldifficulties.
Adaptability:Acertaindegreeofflexibilityinbeliefstructure,emotionalexperienceandworldviewisaprotectivefactor.
Tendencytofindmeaning:Anaturaltendencytofindmeaningandpurposeinevents,especiallystressfuleventsthatchallengeanindividual,isanotherpro
tectivefactor.
Curiosityandopennesstoexperience.Curiosityandopennesstonewexperi
encesarerelatedtoadaptability,hardinessandresilience.
Aptitude:Resourcefulness,intellectualmasteryandgeneralcapabilityareprotectivefactors.
Riskfactors ProtectiveFactors
Thenatureandintensityofanytraumatic
eventsexperiencedinthepast
Thenatureandintensityofthetraumatic
orstressfuleventsthattriggerthecurrent
reactions
Thenumber
of
stressors
experienced
Thelengthofexposuretostressfulsitua
tions
Organizationalfactors
Historyofpreviouspsychiatricillness
Lackofsocialsupport
Pronouncedintroversion
Negativityandpessimism
Socialsupport
Optimismandhealthyselfesteem
Spirituality
Adaptability
Tendencytofindmeaning
Curiosityand
openness
to
experi
ence
Aptitude
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
20/35
Understandingandcopingwithtraumaticstress
Headington Institute 200719
Forpersonalreflection
Whichoftheseriskandprotectivefactorscanyourecognizeinyourownlife
history,currentsituation,andpersonality?
Howdoyouseethesefactorsinteractingwiththestressyouexperience?
Forpersonalreflection
Whichoftheseriskandprotectivefactorscanyourecognizeinyourownlife
history,currentsituation,andpersonality?
Howdoyouseethesefactorsinteractingwiththestressyouexperience?
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
21/35
Headington Institute 200720
PartSix:Burnout
Asstressaccumulatesandstaysathighlevelsforextendedperiodsoftime,humanitar
ianworkersrunanincreasedriskofexperiencingburnout.Burnoutisaprocess,notan
event.Thistermreferstoatypeofcumulativestressreactionthatoccursafterpro
longedexposuretooccupationalstressors.Prolongedexposuretoemotionallyde
mandingsituationswithinadequatesupportgraduallydepletesanindividualsown
naturalresourcesfordealingwithstressandstrain.
Thefollowingareoccupationalsituationsthattypicallycontributetoburnout:
Conflictbetweenindividualvaluesandorganizationalgoalsanddemands
Lackofmanagerialand/orsocialsupport
Overloadofresponsibility
Roleconfusion
Senseofhavingnocontroloverqualityoroutcomeofwork
Littleemotionalorfinancialreward
Existenceofinequity,lackofrespect
Consistentexposuretotraumaticmaterial
Inthe
humanitarian
field,
the
road
to
burnout
is
often
paved
with
good
intentions.
Thosewhocomeintoajoboranoverseasassignmentthinkingthatitsgoingtobethe
solutiontoalltheirproblems,whohaveextremelyandunrealisticallyhighhopesand
expectationsaboutthechangetheywillmake,andwhowouldratherworkthando
anythingelse,areprimecandidatesforburnout.Thereisnothingwrongwithbeing
idealistic,ahardworkingperfectionist,oraselfmotivatingachiever.Theproblemlies
intherealityorunrealityoftheidealsandexpectations.Unrealistic,highlyidealisticjob
expectationsandaspirationsaredoomedtoleadtofailureandfrustration.
Aswithothertypesofstressreactions,peopletendtoexperienceburnoutindifferent
ways.
However,
normal
signs
of
burnout
do
tend
to
cluster
in
physical,
emotional,
mental,spiritualandbehavioraldomains.Thefollowingaresomecommonsignsof
burnout.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
22/35
Understandingandcopingwithtraumaticstress
Headington Institute 200721
What is the best defense against burnout?
Thefirstandbestlineofdefenseagainstburnoutisprevention!Apartfromcultivating
acertainsenseofrealism,oneofthebestthingsyoucandotoavoidburnoutisto
createbalanceinyourlife.Investmoreinfamilyandotherpersonalrelationships,so
cialactivitiesandhobbies.Spreadyourselfoutsothatyourjobdoesnthavesuchan
overpoweringinfluenceonyourselfconceptandselfesteem.Asyoureadthroughthe
finalsectionsofthismodule,thoughtfullyexamineyourselfcarepractices.Theywill
helppreventordinarystressfrombecomingdistress,anddistressfrombecomingburn
out.
Physical Mental Emotional Spiritual Behavioral
Exhaustion
Headaches
Highblood
pressure
Insomnia
Dreams
Backpainand
otherchronic
tensionlinked
pain
Stomachcom
plaints
Selfdoubt
Blame
Negativity
Disillusionment
Reducedsense
ofaccomplish
mentandpur
pose
Feelingunappre
ciatedorbe
trayedbythe
organization
Foggythinking
Mentalapathy
Lackofinsight
intoreduced
capacitytofunc
tionwell
Emotionalex
haustionand
fragility
Feelingover
whelmed
Feelinghelp
less
Hopelessness
Mistrustof
colleaguesand
supervisors
Depression
Anxiety
Apathy
Inability
toengage
Wounded
ideals
Cynicism
Declineinper
formance
Apathy
Boredom
Interpersonal
difficulties
Irritability
Increasedad
dictionsor
de
pendencies
Recklessbe
havior
Neglecting
onesown
safetyand
physicalneeds
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
23/35
Headington Institute 200722
Forpersonalreflection
Haveyounoticedanyofthesegeneralsignsofburnoutlately?
Followthislink(http://www.headingtoninstitute.org/Default.aspx?
tabid=1379)toanselfexaminationscaleifyouwouldliketoexplorewhetheryoumightbedemonstratingsignsofburnout.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
24/35
Understandingandcopingwithtraumaticstress
Headington Institute 200723
PartSeven:Examiningyourownwell-being
Inthelongrun,takingcareofourownwellbeingisanessentialprerequisiteforeffec
tivelyhelpingothers.Itisoneofthebestwaystomaintainfitnesstocontinueinthat
helpingcapacity.
Thefirststeptotakingcareofyourwellbeinganddealingmoreeffectivelywithstress
andburnoutisunderstandingyourownselfcarestrengthsandneeds.Takingaper
sonalinventoryhelpsyouunderstandwhereyournaturalselfcarestrengthslie,and
whichselfcareareasneedextraattention.
Beforegoingontothefinalsectionofthismodule,pauseforamomentandtakein
ventoryofhowyouaredoing,andidentifywhichhelpfullifestylebalancestrategies
youuseregularly.Forpersonalreflection
Whataresomeofyourtypicalselfcareandcopingstrategies(bothnegative
andpositive)whenyouarestressed,fatigued,oranxious?
Whatsustainsyouinthiswork(i.e.,whatrefreshesyou,energizesyou,and
givesyouhope)? Whathelpfulselfcarestrategiesdoyouwishyouwereusingmoreregu
larly?
Followthislink(http://www.headingtoninstitute.org/Default.aspx?
tabid=1379)toaselfexaminationscaleifyouwouldliketoexplorewhether
Forpersonalreflection
Whataresomeofyourtypicalselfcareandcopingstrategies(bothnegative
andpositive)whenyouarestressed,fatigued,oranxious?
Whatsustainsyouinthiswork(i.e.,whatrefreshesyou,energizesyou,and
givesyouhope)? Whathelpfulselfcarestrategiesdoyouwishyouwereusingmoreregu
larly?
Followthislink(http://www.headingtoninstitute.org/Default.aspx?
tabid=1379)toaselfexaminationscaleifyouwouldliketoexplorewhether
youcurrentlyhavegoodselfcarestrategiesinplacetohelppreventburn
out.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
25/35
Headington Institute 200724
PartEight:Increasingyourwell-being:Combatingstress
andburnoutthroughself-care
Dealingproactivelywithstressisalearnableskilloftensummedupbythephrase
stressmanagement.Theobjectiveofgoodstressmanagementisnotmerelytohelp
yousurviveyourcareer buttohelpyougrowandthriveasaresultofthestressful
challengesthatyoumightface.Inshort,itinvolvesrecognizingnaturalselfcare
strengthsalreadypresentinyourlifeandlearninghowtoapplythese,andadditional
helpfulstrategies,moreconsistently.
Youwillneverbecomesogoodattakingcareofyourselfthatyouleadastressfreelife.
However,thereismuchyoucandotomakesureyouretakingcareofyourselfprop
erly,toimproveyourwellbeing,andtohelpalleviatetraumaticstressreactionssuch
asburnout!Nosingletechniquewillrelieveallyourstress,butpayingattentiontothe
followingthreeareasofselfcarewillbuildupyourhardiness(yourabilitytohandlemorestresswithlessdistress)andyourresilience(yourabilitytobouncebackafterparticularlystressfulortraumaticevents).
Physical
Regularexercise:Exercisingatleastthreetimesaweekwithamixtureofaerobicexercise(e.g.,running,walking,swimming),exertion(e.g.,weights),and
stretching(e.g.,pilates)hasmultiplestressmanagementbenefits.Forexample,
ithelpsourbodiesprocessstressrelatedchemicals,reducesmuscletension,
releasesfeelgoodchemicalscalledendorphins,helpsusstaygenerallyfitter
andhealthier,andimprovesoursleep.Thisisoneofthesinglemosteffective
stressmanagementstrategies.
Sleep:Mostadultsneedbetweensevenandninehoursofsleepanighttofunctionattheirbest.
Healthyeating:Justasyourcarwouldnotrunwellonpoorqualityfuelornofuel
at
all,
our
bodies
and
brains
function
much
better
when
we
provide
them
withtherighttypeoffuel. Drinkingenoughwater:Bythetimeyoufeelthirstyyouvealreadylost2to3
percentofyourbodyfluid.Thislowersyourbloodvolume,makingyourheart
workhardertopumpbloodtoyourbrain.Stayinghydratedisoneoftheeasiest
waystohelpourselvesfunctionwell.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
26/35
Understandingandcopingwithtraumaticstress
Headington Institute 200725
Laughter:Laughterandpositiveemotionsreleasefeelgoodchemicalsthat
acttoundothecardiovasculareffectsofnegativeemotionsandhelpourbodies
relax.
Limitingyourconsumptionofalcohol:Alcoholnotonlylowersourinhibitionsandleadsustodothingswemaynotnormallydo,butitisadepressantand
depletesessentialvitaminsusefulinhelpingustodealwithstress(theBcom
plexvitamins).
Relaxationtechniques:Avarietyofrelaxationtechniques(suchasprogressivemusclerelaxation,diaphragmaticbreathing,visualizationandmeditation)can
beusedtoelicittherelaxationresponse.Thisactstoundothemuscularand
cardiovasculareffects
of
negative
emotions
and
help
our
bodies
relax.
Massage,whirlpool,sauna:Touchandwarmthareeffectivewaysofelicitingarelaxationresponseandcuingourbodiestorelax.
Repetitiveactivities:Repetitiveandabsorbingactivitiessuchascrossstitching,walking,quilting,drawingandcookingcanfunctionasaformofmoving
meditationthatissoothingandrelaxing.
Emotional and relational
Nurturingrelationships
Contactwith
home/friends
through
email,
phone,
tapes
Talking
Humor
Ongoingsupportgroup
Reflection:journaling,writing,meditating,poetry
Creativeactivitysuchasdrawing,sculpting,cooking,paintingandphotography
Movies,books,music
Havingbalancedpriorities
Understandingtraumaticstressandhaverealisticexpectations
Counseling
Therearethreemainthemesapparentintheseemotionalandrelationalselfcaretech
niques:
Interpersonalrelationships:Socialsupportfactorsplayamajorpartindeterminingstressreactionfactorsandvulnerability.Ourrelationshipswitheachother
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
27/35
Headington Institute 200726
aresoimportantthatrecentresearchsuggeststhatitmaybeourrelationships
thatsaveusratherthanourknowledgeandskills(Fawcett,2003,p.124).Ifyou
donthaveastrongsocialsupportnetwork,makeanefforttocreateone.The
mostprotectivesocialnetworksarentnecessarilylarge,buttheyareintercon
nected.Familiesandgroupsoffriendswhoknoweachotherwellareexamples
ofinterconnectednetworks.
Timeaway/distraction:Allowingyourselfabreatherandthechancetostepawayonaregularbasisisanothercrucialemotionalselfcaretechnique.Ideally
youshouldtakesometimeoffeveryweektodisengagefromworkandissues
thatdrainyou.Atleastsomeofthistimeshouldbespentdoingsomethingfun
andrelaxing.
It
is
especially
important
for
humanitarian
workers
to
be
aware
of
thesetypesofboundaries.Workinginthisfieldtendstosensitizeyoutointer
nationalissuesandtheimpactofdisaster,makingitdifficulttodisengageeven
whenyourenotattheoffice.
Storytelling:Beinginvolvedinhumanitarianworkchangespeople.Seekingtounderstandandexpressthesechangesisanimportantmethodfordealingwith
theimpactofthework.Storytellingcantakeseveralformstalkingwithfriends
orcounselors,journaling,andwritingletters,stories,poetry,orothermoreab
stractformsofcreativeactivitysuchaspainting.Writingappearstobeanespe
ciallyeffectivewayofdealingwiththeimpactoftraumaandstress.Writingde
tailedaccounts
of
stressful
events
in
away
that
links
facts
with
feelings
has
beenshowntohaveapositiveimpactonphysicalhealth.
Spiritual
Knowingyourvalues:Wheredoyoutendtofindmeaninginlife?
Participatinginacommunityofmeaningandpurpose
Regulartimesofprayer,reading,meditation
Spirituallymeaningfulconversations
Singingorlisteningtospiritualmusic
Contactwithreligiousleadersorinspiringindividuals
Timewithart,natureormusic
Solitude
Payingattentiontospirituality,justlikephysicalandemotionalselfcare,buildshardi
nessandresilience.Ithelpsyoumaintainperspective,andactsasacompassandan
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
28/35
Understandingandcopingwithtraumaticstress
Headington Institute 200727
anchorwhenyourefeelingoverwhelmed.Itisalmostimpossibletodohumanitarian
workwithoutitaffectingyourworldviewandspirituality,yoursenseofwhatsimpor
tanttoyouinlife,andyoursourceofstrengthandhope.Profoundchallengestospiri
tualityandworldviewaresomeofthemostsignificantchallengesthathumanitarian
workersfaceduringtheircareers.JohnFawcettputsitwell:
Therewillcomeatime,ifyoupursuethiscareerforlong,whenapro
foundlackofunderstandingwillthreatentosweepawayyouractions,
beliefs, achievements and even reason for being. Knowing this chal
lengewillcome,andensuringthatthereareclosefriendswhocanhear
yourquestions
without
harming
you,
is
an
essential
component
to
pre
ventativestressmanagement
(Fawcett,2003,p.154).
Sohowdowefeedourfaith?First,byunderstandingourpersonalvalues,whatwe
tendtofindmostmeaningfulinlife,andhowthisnurturesourspirituality.Second,by
seekingoutthingsthatareinlinewithourdeepestvaluesandwherewetendtofind
meaningthesearethingsthatmakeusfeelwhole,alive,joyful,andconnectedwith
somethingbeyondourselves.Soulfoodlikethistendstoshiftthewayweviewourlife
andthelifearoundus.Somecommonsourcesofsoulfoodareprayer,readingscrip
turaltexts,
religious
services,
meditation,
yoga,
deep
relationships,
nature,
art
and
mu
sic.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
29/35
Headington Institute 200728
Forpersonalreflection
Whichoftheseselfcarestrategiesdoyouuseregularly? Whichdoyoufindmosthelpfultoyou? Whichstrategiesdoyouwishyouusedmoreregularly? Clickhere(http://www.headingtoninstitute.org/Portals/32/resources/
Effective%20self%20care.pdf)todownloadahandypocketcardwithself
careremindersonit.
Physical Emotionalandrelational Spiritual
Regularexercise
Sleep
Healthyeating
Drinkingwater
Laughter
Limitingconsumption
ofalcohol
Relaxationtechniques
Therapeuticmassage,
whirlpool,sauna
Repetitiveactivities
Nurturingrelationships
Contactwithhome/friends
throughemail,phone,
tapes
Talking
Ongoingsupportgroup
Reflection:journaling,
writing,meditating,poetry
Creativeactivities
Movies,books,music
Havingbalancedpriorities
Understandingtraumatic
stressandhavingrealistic
expectations
Counseling
Knowingyourvalues:
Wheredoyoutendtofind
meaninginlife?
Participatinginacommu
nityofmeaningandpur
pose
Regulartimesofprayer,
reading,meditation
Spirituallymeaningfulcon
versations
Singingorlisteningtospiri
tualmusic
Contactwithreligiouslead
ers
Timewithart,natureor
music
Solitude
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
30/35
Understandingandcopingwithtraumaticstress
Headington Institute 200729
Self-Quiz:Testyourknowledge
Choosethebestanswertoeachofthefollowingquestions.Thisquizismeanttotest
yourcomprehensionofthematerialinthemoduleyouhavejustread.Youranswers
willbeautomaticallytalliedattheendofthis20questionquiz.
1. Internationalhumanitarianworkerscommonlyexperiencestressfromwhichofthe
followingsources?
a. Violenceandthreat
b. Socialdislocation
c. Spiritualdislocation
d. Theworkenvironment
e. Alloftheabove
2. Stresscanbedefinedasanydemandorchangethatthehumansystem(mind,
body,spirit)isrequiredtomeetandrespondto.
a. True
b. False
3. Stressbecomesdistress,ortraumaticstress,whenitlaststoolong,occurstooof
ten,or
is
too
severe.
a. True
b. False
4. Somethingthatisverystressfulforonepersonisalwaysstressfulforothers.
a. True:Everyonefindsthesametypesofeventsstressfultothesameextent.
b. False:Yourindividualperception(howthreatenedyoufeelandhowmuch
controlyouhaveoverthecircumstances)caneffectthedegreeofdistress
youpersonallyfeel.
5.
Trauma
reactions
that
occur
as
the
result
of
a
critical
incident
(a
traumatic
event
duringwhichanindividualexperiencesthethreatofseriousharmofdeath)areof
tenreferredtoas:
a. CriticalIncidentStress
b. AcuteStressReactions
c. Bothofthetermsaboveareregularlyusedtorefertothistypeoftrauma
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
31/35
Headington Institute 200730
reaction.
6. Experiencingtraumaticstressreactionsafteracriticalincidentisanormalresponse
toanabnormalsituation.
a. True
b. False
7. Traumaticstressreactionsneveroccurinresponsetowitnessingand/orhearing
abouttraumaticeventsthathavehappenedtoothers.
a. True:Individualsmustbedirectlyinvolvedintraumaticeventstobeim
pactedby
them.
b. False:Interactionwithpeoplewhohaveexperiencedtraumaticevents
placeshelpersatriskofexperiencingsomeformofsecondarytraumatic
stressresponse.
8. Somecommonsourcesofchronicstressforhumanitarianworkersinclude:
a. Aconstantlychaoticandreactiveworkenvironment
b. Feelingoverwhelmedbytheapparentneed
c. Inadequatepreparationandbriefing
d. Beingaskedtocompletetasksoutsidetheirareaoftrainingandcompe
tencee. Alloftheabove
9. Overtime,thepresenceofmultiplechronicstressorsisusuallyabetterpredictorof
higherstresslevelsthantheoccurrenceoftheoccasionalcriticalincident.
a. True
b. False
10.Humanitarianworkersareatriskofexperiencingwhichofthefollowingtypesof
traumaticstress?
a. CriticalIncidentStress
b.
Vicarioustrauma
c. CumulativeStress
d. Alloftheabove
11.Peoplefromdifferentculturesexperienceandexpresstraumaticstressexactlythe
sameway.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
32/35
Understandingandcopingwithtraumaticstress
Headington Institute 200731
a. True
b. False
12.Whichofthefollowingisnotafactorthatincreasestheriskthatyouwillexperi
encetraumaticstressreactions?
a. Natureandintensityofanypasttraumaticeventsexperienced
b. Thenumberofstressfuleventsexperienced
c. Goodsocialsupport
d. Organizationalfactors
e. Historyofpreviouspsychiatricillness
13.Whichofthefollowingisnotanormalsignofcumulativestress?
a. Sleepdisturbances
b. Seeingthingsthatarentthere
c. Fatigue
d. Poorconcentration
e. Eatingmorethannormal
14.Whichofthefollowingstatementsistrue?
a. Burnoutisaprocess,notanevent.Itisatermusedtorefertoatypeofcu
mulativestress
reaction
that
occurs
after
prolonged
exposure
to
occupa
tionalstressors.
b. Burnouthappenssuddenly.Itisanacutebreakdownofpersonalfunction
ingthattendstohappenwithfewwarningsigns.
15. Whichofthefollowingisahelpfulwayofpreventingoralleviatingburnout?
a. Cultivatingacertainsenseofrealismaboutyourjobanditsoutcomes.
b. Createbalanceinyourlife,investmoreinfamilyandotherpersonalrela
tionships,socialactivitiesandhobbies.
c. Bothoftheabovearehelpfulstrategiesinpreventingoralleviatingburnout.
16.When
trying
to
increase
your
hardiness
and
resilience,
it
is
important
to
pay
atten
tiontowhichofthefollowingselfcareareas?
a. Physical
b. Emotionalandrelational
c. Spiritual
d. Itisimportanttopayattentiontoalloftheseareas.
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
33/35
Headington Institute 200732
17.Whichofthefollowingisnotagoodphysicalselfcarestrategy?
a. Regularexercise
b. Gettingenoughsleep
c. Drinkingabottleofwineeverynight
d. Laughing
e. Practicingarelaxationtechnique
18.Whichofthefollowingisnotahelpfulemotionalorrelationalselfcarestrategy?
a. Talkingtoagoodfriend
b. Spendingallyourtimewithpeoplewhoonlyseethenegativesideofsitua
tions
c. Writinginajournal
d. Watchingafunnymovie
e. Understandingstressreactions
19.Profoundchallengestospiritualityandworldviewareusuallysomeofthemostsig
nificantteststhathumanitarianworkersfaceduringtheircareers:
a. True
b. False
20.Which
of
the
following
are
helpful
spiritual
self
care
strategies?
a. Participatinginacommunityofmeaningandpurpose
b. Regulartimesofprayer/reading/meditation
c. Spirituallymeaningfulconversations
d. Timewithart,natureormusic
e. Alloftheabove
Quiz:
(1) e
(2)
a(3) a
(4) b
(5) c
(6) a
(7) b
(8) e
(9) a
(10) d
(11) b
(12)c(13) b
(14) a
(15) c
(16) d
(17) c
(18) b
(19) a
(20) e
8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
34/35
Understandingandcopingwithtraumaticstress
Headington Institute 200733
Resources
Thismoduleprovidesanintroductiontothephenomenonoftraumaticstress.Itisin
tendedtoprovideyouwithsomebasicinformationaboutstressandcopingandguide
youtowardsadditionalresourcesthatwillenhanceyourunderstandingofthistopic.
Helpfulwebsitesandbooksarelistedbelow.
PleasecontacttheHeadingtonInstituteatinfo@headingtoninstitute.org,orphone
(626)2299336ifyoudlikemoreinformation,wishtospeaktoamentalhealthprofes
sional,ordesireaprofessionalreferral.
On the internetPsychosocial.org:http://www.psychosocial.org/
MobileMemberCareTeamforMissionaries:http://www.mmct.org/resources.htm
InternationalSocietyforTraumaticStressStudies:http://www.istss.org/
BaldwinsTraumaInformationPages: http://www.traumapages.com/
TheSidran
Institute
for
Traumatic
Stress
Education
and
Advocacy:
http://
www.sidran.org/index.html
Risksassociatedwiththepsychologicaladjustmentofhumanitarianaidworkers:
http://www.massey.ac.nz/~trauma/issues/20041/mcfarlane.htm
BooksSharingthefrontlineandthebackhills:Peacekeepers,humanitarianaidworkersandthemediainthemidstofcrisis(2002).EditedbyYaelDanieli.PublishedbyBaywoodPublishingCompany,Inc.
Thehumanitariancompanion(2004).WrittenbyJohnEhrenreich.PublishedbyIDTGPublishing.
Stressandtraumahandbook:Strategiesforflourishingindemandingenvironments(2003).EditedbyJohnFawcett.PublishedbyWorldVisionInternational.
mailto:staff@headington-institute.orgmailto:staff@headington-institute.orgmailto:staff@headington-institute.orghttp://www.istss.org/http://www.istss.org/http://www.istss.org/mailto:staff@headington-institute.org8/14/2019 English Translation Understanding and Coping With Traumatic Stress Final
35/35
StressManagementfordummies(1999).WrittenbyAllenElkin.PublishedbyWileyPublishing,Inc.